Individual provider Active NPI

Marcus Zachariah, M.D., PH.D.

  • Neurological Surgery Physician
  • San Diego, CA
National Provider Identifier
1477817187
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
35135874 Issued in OH
Practice address
3750 Convoy St Ste 301
San Diego, CA 92111-3741
Phone
(619) 297-4481
Fax
(858) 429-7666
NPI assigned
Jun 27, 2012
Last updated
Nov 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 35135874 OH Primary

Addresses

Primary practice location

3750 Convoy St Ste 301
San Diego, CA 92111-3741

Mailing address

3750 Convoy St Ste 301
San Diego, CA 92111-3741
Phone (619) 297-4481

Other identifiers 1

IdentifierTypeStateIssuer
0401107MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230104000638 CA Practitioner - Neurosurgery 6507019734 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of California, San Francisco School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurosurgical Medical Clinic IncGroup PAC ID 3375584287, 10 clinicians
Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

Practice addresses (Care Compare)

3750 Convoy St
Suite 301
San Diego, CA 92111-3741
Phone (619) 297-4481

7901 Frost St
San Diego, CA 92123-2701
Phone (858) 939-3400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion141
Laminectomy or laminotomy (partial removal of spine bones)28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35135874OHMDNeurological Surgery Physician
251899MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Apr 24, 2023 Accepting new patients
Neurosurgical Medical Clinic, Inc, Neurological Surgery CurrentSince Dec 22, 2022 Accepting new patients
On Call Specialists Medical Group of San Diego, Inc. CurrentSince May 15, 2025 Accepting new patients
Duke Health Lake Norman Regional Medical Center, Inc. Past Accepting new patients
Trias Global, LLC Past Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

5565 Grossmont Center Dr
Ste 210
La Mesa, CA 91942
Phone (619) 461-3150

3750 Convoy St
Ste 201
San Diego, CA 92111
Phone (858) 278-8031

3750 Convoy St
Ste 301
San Diego, CA 92111
Phone (858) 309-7702

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

650 E Devon Ave
Ste 165
Itasca, IL 60143
Phone (630) 285-1040

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mzachariah34590@sharphealthcare.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1477817187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 CONVOY ST STE 301",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113741",
            "telephone_number": "619-297-4481",
            "fax_number": "858-429-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CONVOY ST STE 301",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113741",
            "telephone_number": "619-297-4481",
            "fax_number": "858-429-7666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARIAH",
        "first_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OH",
            "license": "35135874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0401107",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.